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HomeTopicsPersonality DisordersNarcissistic Disorder
Narcissism and Narcissistic Personality Disorder: Placing Self FirstNarcissistic personality disorder produces feelings of exaggerated self-worth and personal importance. To the narcissist the world and other people exist only to verify his or her superiority and to cater to all his or her needs. The disorder is characterized by a lack of regard or empathy for others, selfishness, and an unrealistic sense of self-entitlement in all situations. Causes of Narcissistic Personality DisorderThe cause of narcissistic personality disorder is unknown, but narcissism usually develops in early adulthood. While elements of narcissism may be present during adolescence, this can be part of a person's normal development that diminishes with maturity. For this reason, diagnosis of narcissistic personality disorder is not made before adulthood.
Symptoms of NarcissismNarcissistic personality disorder symptoms stem from the narcissist's self-absorption and over-exaggerated sense of self-worth. People with narcissistic personality disorder are quite willing to take advantage of, manipulate, or lie to others to achieve their own desires and gratification. When a narcissist values a person, it is only because that person has something to offer. Narcissism reduces other people to the status of servants or useful tools.
Common symptoms include:
Narcissistic Personality Disorder and Relationships The attitude of a narcissist towards others is one of superior contempt. Narcissism also makes people envy the accomplishments of others; the success of others is perceived as stealing the narcissist's "rightful" rewards or possessions.People with narcissistic personality disorder demand that others provide them with comfort, gifts, and other desires, but refuse to acknowledge any indebtedness. Rather than offer thanks, the narcissist will mock and degrade both gift and giver. This contempt for others is also expressed towards intimate partners and children. When narcissists feel family members are not meeting their needs, they may resort to emotional, physical, or sexual abuse. Sexual abuse of children is also a danger with severe narcissist personality disorder, as the narcissist sees his children as extensions of his self with no real individual identity or rights. Narcissism and Reality ConflictsThe self-importance characteristic of narcissism and the narcissist's demand for preferential treatment will inevitably come into conflict with reality. Narcissists are adept at explaining discrepancies between reality and their self-image, but occasionally circumstances shake the narcissist's belief in his superiority. When this happens, the person may become enraged, experience feelings of emptiness, or develop clinical depression.
Diagnosing Narcissistic Personality DisorderSeeking treatment for narcissism is rare. The narcissistic individual sees nothing wrong with his or her narcissism; to narcissists, their "natural" superiority is obvious to them, and therefore should be obvious to all.
When narcissists seek medical help, it's usually because their self-image has been disrupted by an occurrence that casts doubt on their assumed superiority. Such a crisis can result in clinical anxiety and depression, and it if for these emotions that the narcissist seeks treatment. Diagnosis of narcissistic personality disorder requires a thorough psychological evaluation, the gathering of personal history, and personal observations made by the diagnosing doctor. In accordance with the DSM-IV, a diagnosis of narcissistic personality disorder is considered when five or more of the following criteria are present:
A number of conditions can mimic symptoms of narcissism, and must be ruled out before a definitive diagnosis is possible. These conditions include:
Narcissistic TreatmentNarcissism treatment must overcome a number of challenges. People with narcissistic personality disorder often resist treatment; their self-concept refuses to accept that their narcissism is abnormal, and they consider mental treatment "beneath them," or "demeaning" and they adopt adversarial attitudes towards mental professionals.
Antidepressants may be used to treat anxiety and depression in the narcissist, but as with many personality disorders, the patient must be monitored carefully for signs of noncompliance or substance abuse. Psychotherapy, both individually and in group settings, can help the patient with narcissistic personality disorder identify and change his or her symptoms. The goal of treatment is to help the narcissist become more sensitive to others' rights and emotions. Treatment outcomes are dependent on the severity of the disorder — the less willing the narcissist is to view others with any degree of empathy, the more likely treatment will fail. Resources American Psychiatric Association. Diagnostic criteria for 301.81: Narcissistic personality disorder. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. American Psychiatric Association, Washington, DC, 1994. Ekleberry, S. (2000). Dual diagnosis and narcissistic personality disorder. Long, P. (nd). Narcissistic personality disorder. Narcissistic Personality Disorder.com. (nd). What is narcissism? National Library of Medicine. (updated 2003). Narcissistic personality disorder. MedlinePlus Medical Encyclopedia . Vaknin, S. (nd). Ideas of reference.
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